Derbenwick, Mary June

Derbenwick, Mary June is an individual health care provider with primary practice located at 350 N Clyde Morris Blvd , Daytona Beach FL 32114-2733. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Neurology, which is considered as her primary health care specialty. Derbenwick, Mary June can be contacted via phone (386) 238-3244.

Contact Information

Primary practice address
350 N Clyde Morris Blvd Daytona Beach FL 32114-2733
Phone: (386) 238-3244
Fax: (386) 238-3269
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X ME0028487 Florida

Profile Details

NPI number 1063405975
LBN Legal business name Derbenwick, Mary June
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2005
Last updated Jun 23rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063405975 NPPES
Florida Other 64322 BCBS
Florida Other 1063405975 BCBS
Florida Other 1063405975 BCBS

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